Laparoscopic surgery for ectopic pregnancy

The article was professionally consulted by MSc, Dr. Trinh Thi Thanh Huyen - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital

Laparoscopic ectopic pregnancy is an effective treatment method in cases of unruptured ectopic pregnancy or ruptured ectopic pregnancy with a small amount of intra-abdominal blood, not affecting the overall condition. of the patient. An ectopic pregnancy is a condition in which a fertilized egg implants outside the uterus. These locations can be the fallopian tubes (accounting for 95-98%), ovaries, cervical canal and abdominal cavity.

The patient has been diagnosed with an ectopic pregnancy, with stable vital signs (pulse, temperature, blood pressure, breathing rate). In patients with suspected ectopic pregnancy, high-risk diagnosis is based on Bruhat's risk factor rating scale:

Selection of treatment methods for ectopic pregnancy is based on the following points:
0 - 3 points : Treatment is by laparoscopic surgery to preserve the fallopian tubes if the patient wishes to give birth.
4 point : Treatment with laparoscopic tubal resection.
≥ 5 points : Laparoscopic hysterectomy and sterilization of the opposite side.

Laparoscopic ectopic pregnancy is indicated for cases of ectopic pregnancy but not ruptured torsion. This procedure is to ensure the safety of the mother's health. The duration of laparoscopic ectopic pregnancy surgery will depend on each specific case.
In particular, the complexity of laparoscopic ectopic pregnancy as well as the skill of the surgeon will affect the time to conduct laparoscopic ectopic pregnancy.
Steps to perform laparoscopic ectopic pregnancy include:
Stage 1: CO2 injection
Stage 2: Trocar puncture
Stage 3: Evaluation of the abdomen and pelvis
Stage 4: Surgery: Depends on the damage
Hysterectomy from the waist to the speaker or vice versa Preservation of the uterus: Open the uterus Remove the pregnancy mass from the uterus Check the bleeding and stop the bleeding Take specimens End of surgery After laparoscopic ectopic pregnancy, yes Some complications may occur such as:
Bleeding: During adhesion removal, hemostasis is not good, damage to the mesentery of the fallopian tubes, the branches connecting the ovarian artery and the uterine artery Injury to other organs : Due to the ectopic pregnancy attached to the intestine, the pelvic wall. Injury to the intestines: Due to a lot of adhesions and heavy bleeding. Presence of trophoblasts: Due to the reason that the specimen is not completely removed so that the trophoblasts fall into the abdomen and continue to grow.